Consider the instructions for use and contraindications of "Indapamide". This medicine with vasodilating, diuretic and antihypertensive properties. It is produced by several foreign and Russian pharmaceutical companies: Teva (Israel), PRANAFARM LLC, Valenta Pharmaceuticals OJSC (Russia), German STADA Artsnaymittel, Hemofarm (Serbia and Montenegro), and Ukrainian Stoma JSC.
Composition and form of release
About contraindications and side effects of "Indapamide" we will tell below. In the meantime, we will understand what is in the composition of the medication.
It comes in several forms:
- Capsules that are packaged in blister packs of 5, 6, 7, 10, 30 pcs. or in banks of 10, 20, 30, 40, 50, 100 pcs.
- Long-acting tablets in the shell - in blisters of 10 pcs. or 30 pcs. in the banks.
- Tablets in a modified release shell - in blister packs of 10 and 14 pcs.
The composition of this medication contains an active element - indapamide. The auxiliary components of the capsules are: magnesium stearate, microcrystalline cellulose. Additional substances in the composition of tablets: hypromellose, lactose monohydrate, magnesium stearate, colloidal anhydrous silicon dioxide, polyethylene glycol, croscarmellose sodium, crospovidone, povidone K30, talc, sodium lauryl sulfate. Indapamide contraindications are important to determine in advance.
pharmachologic effect
This is a sulfonamide derivative, and its pharmacological effect is similar to that of thiazide diuretics. The medication has diuretic and saluretic effects of moderate severity due to a slowdown in the reabsorption of sodium, chlorine and, to some extent, potassium and magnesium ions in the proximal tubules of the kidneys and the cortical region of the distal tubule of the nephron.
This pharmaceutical agent allows you to reduce the tone of smooth arterial muscles, has a vasodilating property, and also reduces systemic peripheral vascular resistance. These actions of the drug are due to a decrease in the reactivity of the vascular walls to norepinephrine and angiotensin II, the suppression of calcium flow in the cells of vascular smooth fibers, and the activation of prostaglandin E2 production, which is characterized by a vasodilating property.
When using the drug "Indapamide" there is a decrease in left ventricular hypertrophy in the heart. The substance has antihypertensive properties when taken in dosages that do not have a significant diuretic effect. After increasing a certain dose, thiazide-like and thiazide diuretics are characterized by the formation of a plateau of the therapeutic effect, while the degree of undesirable side effects continues to increase. Therefore, increasing the dose of the drug is not recommended if during therapy at the recommended dosage a positive effect is not achieved. And, of course, one should keep in mind the contraindications of Indapamide tablets, which are described below.
Indications for use
A medication is prescribed in the treatment of hypertension. This medicine should not be used without consulting a doctor.
The list of contraindications "Indapamide"
The presence of the following pathological conditions must be reported to the attending doctor. The following diseases should be noted as contraindications to Indapamide:
- renal failure (severe, in the stage of anuria);
- galactosemia;
- hypokalemia;
- severe liver failure (including with encephalopathy);
- impaired glucose / galactose absorption, lactose intolerance;
- combined use with drugs that help prolong the QT interval;
- period of pregnancy, lactation;
- excessive sensitivity to the composition of the drug, as well as to other sulfonamide derivatives;
- age less than 18 years (the effectiveness and safety of the use of the medication for this age category have not been established).
Use with caution
In general, contraindications for Indapamide should be strictly observed. In addition to the main ones, there are also relative ones. The medicine should be used with caution in the following situations:
- with functional disorders of the liver or kidneys;
- with diabetes mellitus (decompensation stage);
- with hyperuricemia (if accompanied by gout and urate nephrolithiasis);
- in violation of the water or electrolyte balance;
- with hyperparathyroidism, with an increased QT interval on the ECG;
- people receiving antiarrhythmic drugs.
Instructions for use
If there are no contraindications to the tablets "Indapamide", then before taking it is necessary to familiarize yourself with the instructions. This medical product is taken orally in the morning, once, washed down with liquid and does not chew. Daily dosage - 1 pc. (in the form of tablets with modified release or prolonged exposure, as well as capsules). If after 1-2 months of using the drug the necessary therapeutic effect is not observed, it is not recommended to increase the dosage of the drug (due to the high risk of side effects without increasing antihypertensive effects). In such cases, it is desirable to include other antihypertensive agents that are not diuretics in the drug treatment regimen.
While taking two different medicines, there is no need to adjust the dosage. If contraindications are taken into account and the Indapamide instruction is studied properly, then the likelihood of developing negative reactions will be less.
Side effects
In the process of therapy using this medication, the development of some pathological conditions is possible:
- Heart and blood vessels: orthostatic hypotension, ECG disorders (hypokalemia), arrhythmia, heart palpitations.
- CNS: asthenia, nervousness, cephalgia, dizziness, drowsiness, sleep disturbance, depression, vertigo, malaise, increased fatigue, severe weakness, muscle spasm, tension, irritability, anxiety.
- Digestive system: abdominal pain, dry mouth, nausea, anorexia, gastralgia, vomiting, constipation, diarrhea, the occurrence of hepatic encephalopathy and pancreatitis.
- Urinary system: frequent infectious pathologies, nocturia, polyuria. But, of course, contraindications and side effects of Indapamide are not always interconnected. In some cases, the drug is allowed to be taken, but it still causes negative reactions of the body.
- Respiratory organs: pharyngitis, sinusitis, rhinitis, cough.
- The hematopoietic system: leukopenia, thrombocytopenia, agranulocytosis, bone marrow aplasia and hemolytic type anemia.
- Laboratory indicators: hyperuricemia, hypercalcemia, hypokalemia, hyponatremia, hyperglycemia, hypochloremia, increased nitrogen, as well as plasma urea, hypercreatininemia, glucosuria.
- Allergic reactions: rashes, hemorrhagic vasculitis, pruritus. Hives.
- Other pathological phenomena: exacerbation of lupus erythematosus.
Overdose symptoms
It is important not only to consider contraindications for the use of Indapamide, but also to strictly observe the dosage. You can determine the development of a drug overdose condition by such signs as oliguria or polyuria up to anuria (as a result of hypovolemia), a sharp decrease in pressure, water-electrolyte changes (hyponatremia, hypokalemia), respiratory center depression, drowsiness, lethargy, confused consciousness, convulsive seizures, dizziness, nausea, vomiting. In patients with cirrhosis of the liver, hepatic coma may occur. As therapy, symptomatic treatment is recommended (gastric lavage, sorbent intake, measures to normalize water-electrolyte balance).
Special recommendations
Indications and contraindications "Indapamide" are described in detail in the instructions. It is recommended that elderly patients and people taking glycosides and laxatives against hyperaldosteronism regularly monitor the content of creatinine and potassium ions. During therapy with Indapamide, it is necessary to systematically monitor the content of magnesium, sodium and potassium ions in the plasma (due to the possibility of electrolyte disturbances), residual nitrogen, glucose, uric acid, as well as the pH level. An initial study of potassium levels is done in the first week of treatment. High-risk categories also include people with an extended QT interval on the ECG (of a congenital type or developed against the background of a certain pathological process).
People with liver cirrhosis (mainly with swelling or ascites, which is associated with the likelihood of metabolic alkalosis, which increases the severity of liver encephalopathy), ischemic heart disease, heart failure, as well as elderly patients, need close monitoring. Hypercalcemia, which developed during the use of the medication, may indicate previously undiagnosed hyperparathyroidism.
In addition, it is recommended to control glucose levels in people with diabetes. Significant dehydration can lead to acute kidney failure (decreased glomerular filtration). Patients need to compensate for the loss of fluid in the body and at the beginning of therapeutic measures to control the functionality of the kidneys.
The drug "Indapamide" can give positive results in the implementation of doping control. In case of hyponatremia and arterial hypertension 3 days before the start of the use of angiotensin-converting enzyme inhibitors, it is necessary to interrupt the intake of diuretics or to use the initial angiotensin-converting enzyme inhibitors in small doses. Derivatives of sulfonamides can provoke exacerbation of lupus erythematosus. In some cases, individual effects associated with changes in blood pressure are possible during treatment, including when another antihypertensive drug is included in the therapeutic regimen. As a result of this, the ability to drive vehicles and perform work that requires concentration should be reduced.
Prescription for lactation and pregnancy
The use of the medicinal product “Indapamide” during pregnancy is not recommended, since its administration can provoke fetoplacental ischemia, which can slow the development of the fetus. Since the main element of the drug passes into breast milk, it should not be prescribed during lactation. If it is necessary to take the medicine by nursing patients, breastfeeding should be suspended. It is better to collect information in advance about contraindications and side effects of Indapamide.
Drug interaction
With the concomitant use of the drug with other medical devices, undesirable effects may develop:
- cardiac glycosides, as well as laxatives, saluretics, tetracosactides, amphotericin B, gluco- and mineralocorticoids: increased likelihood of hypokalemia and digital intoxication;
- astemizole, erythromycin, pentamidine, terfenadine, vincamine, sultopride, antiarrhythmic medicines of class IA (quinidine, disopyramide) and class III (amiodarone, sotalol): arrhythmia of the type “pirouette”;
- anti-inflammatory non-steroidal medicines, tetracosactide, glucocorticosteroids, sympathomimetics: decrease in antihypertensive property;
- tricyclic (imipramine) antidepressants and antipsychotics: increased hypotensive effects and increased likelihood of orthostatic hypotension;
- calcium preparations: the likelihood of developing hypercalcemia;
- metformin: the likelihood of increased symptoms of lactic acidosis;
- cyclosporine: risk of developing hypercreatininemia;
- iodine-containing contrast agents in high dosages: the risk of developing renal dysfunction and dehydration (before the introduction of iodine-containing substances, it is recommended to restore fluid loss);
- angiotensin-converting enzyme inhibitors: the risk of acute renal failure and arterial hypotension (especially with diagnosed renal artery stenosis);
- baclofen: increased hypotensive effect;
- indirect anticoagulants (coumarin or indandion derivatives): suppression of their effect (dose adjustment necessary);
- potassium-sparing diuretics: the occurrence of hyper- or hypokalemia;
- non-depolarizing muscle relaxants: the blockade of neuromuscular transmission that develops under their influence is intensified.
The medicine “Indapamide” increases the concentration of lithium ions in the plasma (inhibition of urinary excretion), and lithium, in turn, has a nephrotoxic effect.
Analogs
Among the analogues of the pharmacological agent "Indapamide" it should be noted:
- "Indapamide Retard."
- "Indapamide-Teva."
- Arifon Retard.
- "Indapamide MV Stad."
- "Ionik."
- Indap.
- Tenzar.
- Lorvas.
- Indapen.
- Indopres.
- Acrylamide.
- "Hydrochlorothiazide".
- Cyclomethiazide.
- "Oxodoline."
Price
On average, the cost of the drug Indapamide in the form of capsules varies from 22 to 30 rubles (30 pcs. Per pack). The price of tablets for long-term exposure is approximately 90-140 rubles (30 pcs.). Tablets with modified release cost about 100-107 rubles (30 pcs.).
We will find out if there are contraindications for Indapamide Retard 1.5 mg.
Difference of funds
In addition to the classic drug Indapamide, on the shelves of pharmacies you can find the drug Indapamide Retard, 1.5 mg. These agents contain the same active element and have identical indications for use. As for contraindications and side effects, Indapamide Retard is exactly the same as the usual drug.
However, in a sense, these drugs are different, and the most obvious difference is from different manufacturers. Another difference in medication is the mechanism by which the basic substance is released. The half-life of drugs also varies, and because of this, the latter has a prolonged property.
Reviews about contraindications and side effects of "Indapamide"
Not only patients who were prescribed Indapamide, but also medical specialists who say that this medicine should never be taken on their own, without a doctor’s appointment, have left their opinions on this drug. This is due to the fact that in the treatment of hypertension it is necessary to clearly diagnose the disease, choose the right dosage, and minimize the likelihood of negative consequences, which in the case of this drug can be quite serious. Doctors also indicate that if it is possible to prescribe another, safer remedy for pressure, it is better not to use this medication.
Patients who took the drug "Indapamide", in the reviews note that at the first stages of treatment it almost always causes side effects. These are digestive disorders and changes in the functioning of the nervous system, which are characterized by dizziness, drowsiness, excessive weakness and lethargy. Many people had frequent headaches while taking Indapamide. Patients often had dyspeptic disorders and stool disorders. The therapeutic effect, according to patients, when taking the medicine in most cases was achieved.
We reviewed the instructions, indications and contraindications of "Indapamide".